Diagnostic utility of an echo-contrast agent in patients with synovitis using power Doppler ultrasound: a preliminary study with comparison to contrast-enhanced MRI

The purpose of this study was to first evaluate Levovist (Schering, Berlin, Germany), an echo-contrast agent, during power Doppler sonography (PDS) in patients with synovitis using asymptomatic joints as controls. Then we eva luated the accuracy of this technique against contrast-enhanced MRI. Forty patients (19 men and 21 women; mean age 40 years) were enrolled on the basi s of clinical signs, laboratory tests, and radiographic findings positive f or articular inflammatory disease. They were examined with conventional ult rasonography (US) and PDS techniques before and after intravenous contrast medium injection. Fourteen patients then underwent MRI with and without con trast medium 8-14 days after PDS studies. Three expert readers independentl y evaluated each examination. After contrast medium, synovium in inflammato ry arthritis enhanced on PDS compared with normal joints in the same patien t. Power Doppler sonography after contrast medium and MRI were concordant i n all cases. Power Doppler sonography with contrast medium showed a qualita tive increase in signal from synovial vessels, the first sign of synovial c hanges in inflammatory diseases.